Category: Shoulder Pain

Swimmer’s shoulder is an inflammatory condition that got its name from the common occurrence of shoulder pain that swimmers get from overuse during training. Patients experience a musculoskeletal pain that can extend from the shoulder joint to the neck and arms.

Cause

Patients get swimmer’s shoulder from recurring traumatic impact on the shoulder over a period of time of overtraining or impaired posture from poor swimming/paddling techniques. The muscles and ligaments in the shoulder are overworked and if the condition is ignored and untreated, it may lead to more serious injuries like rotator cuff tears or cartilage damage. The rotator cuff is the main group of muscles that controls the shoulder movements and keeps the shoulder centred on the joint. If the shoulder ball goes out of place, the shoulder would be dislocated.

Prevention

Since swimmer’s shoulder occurs gradually with repetitive movements, it is more effective to prevent the injury by correcting the stroke techniques than treating it when after it occurs.

To prevent the injury, swimmers have to use proper strokes with the hand facing flat and fingertips first entering the water. The shoulders are pulled back and chest thrust forward. However, take note that the body is still relaxed and not tensed up. Make sure that the arms are not fully straightened or dropped. This wrong method produces a push down force and puts stress on the shoulder muscles. Raise the elbows a little and keep it slightly bent to effectively press back against the water.

The proper technique should utilise the chest muscles and not just the shoulders. You would also find yourself swimming more efficiently with the generated force fully pushed backwards, propelling you forward faster.

Be careful of wearing out the shoulder muscles when there are changes in training techniques or an increase in training frequency. Ease in the changes gradually to let your muscles strengthen up and get used to the training.

You can also prevent it by stretching your shoulder, chest and neck muscles regularly. It helps to warm up the muscles and keep them flexible.

Treatment

You can apply the basic treatment method of RICE – Rest, Ice, Compression, Elevation – if the condition is recognised early on. Just icing can also help reduce the pain and swelling.

If your condition does not improve with the basic methods of treatment or the pain keeps recurring, you may have to see a physiotherapist to manage the injury. Regular physiotherapy sessions would help strengthen the muscles and correct your posture. Your physiotherapist would advise you to rest your arm as much as possible and even wear a sling to keep the weight off your shoulders. You may have to sleep upright or with a pillow support.

A doctor may prescribe you anti-inflammatory and pain medicine to reduce the pain and swelling faster. But just the medicine will not treat the root of the problem. The healing process only begins with proper exercises done in physiotherapy and utilizing preventive methods to avoid further aggravating the injury.

The shoulder joint is composed of three different types of bones: the shoulder blade, upper arm bone and collarbone. This type of joint is a ball and socket joint, allowing for extreme flexibility and wide range of motion. The upper arm bone acts like a ball and is securely inside the shoulder blade socket. For stabilization purposes, the upper arm bone is slightly larger than the socket, ensuring that the fit is tight. To further enhance the stability, there is a layer of soft tissue called the labrum. Injuries to the labrum is the cause of a shoulder joint tear. In this article, we will look at some of the symptoms and preventive measures.

Symptoms of Glenoid Labrum tears are difficult to be diagnosed. The pain is unable to be localized to the exact location and pain is severely increased when actions involving the injured shoulder is attempted. Such actions can include stretching the arm or raising a hand. As time passes, the shoulder will be weaker and instability will start to set in.

Shoulder joint tears are often caused by a sudden trauma to the shoulder blade. These can include falling on an outstretched arm or a direct blow to the shoulder. In order to prevent this, protective measures should be taken:

Warm-ups and stretching

Have you ever taken a rubber band and pulled it suddenly? The rubber band will end up breaking immediately. This is the same for our muscles and it is the reason why warm ups and stretching are extremely important. Warming up will loosen the muscles and enable the tendons and ligaments to stretch. This will allow them to function properly and hold the shoulder joint together.

Protective gears

Shoulder joint tears are also much more common in players engaging in high impact sports such as rugby and baseball. Players often wear protective paddings designed for the shoulder. These cushioning pads are able to cushion and absorb shocks to a certain extent. Some are even able to prevent fractures and dislocations.

Build strong muscles

Building up strength in the shoulders will increase the ability of tendons, ligaments and muscles to withstand the impact experienced by the shoulder. Strong muscles will hold the shoulder together and prevent any muscular tears during an impact.

Shoulder joint tears are extremely painful and affects our daily lifestyle. Players who participate in high impact or repetitive sports shoulder consider investing in good protective gears and ensure that proper warm ups are performed prior to the start of their activity.

Frozen shoulder as its name suggests is a medical condition affecting the shoulder joint where it becomes swollen and stiff as though it is frozen. Our shoulder is a ball and socket joint designed for a wide range of motion and flexibility. Frozen shoulder is a condition that happens slowly over time and will also go away after a year. It may happen after injuries or diseases such as diabetes or stroke. Patients with frozen shoulder will have the formation of scar tissues in the shoulder capsule, causing it to thicken.

There is still no full understanding as to why frozen shoulder occurs. However, there are a few possible causes that are attributed to it:

Previous injury associated with shoulder

Patients who have had past shoulder injuries or surgeries such as a fracture or shoulder replacement may experience frozen shoulder. This is largely due to the post-recovery process requiring them to have large amounts of immobilization time. As a result, the shoulder capsule tightens over time and result in it freezing.

Diabetes

Patients who suffer from diabetes are twice as likely to develop frozen shoulder though the mechanism is still unknown. It could be due to the large buildup of collagen in the shoulder joint. Diabetic patients have large amount of glucose molecules in the body and these excess glucose will attach themselves to the collagen, causing them to stiffen up.

The most common and obvious symptom of frozen shoulder is persistence pain and stiffness in the shoulder joint. Symptoms usually develop slowly over time, usually within a two year timeline.

There are three stages of frozen shoulder:

Pain stage – This is the initial stage where the shoulder will become slightly stiff and the pain increases when any movement is made on the shoulder. This will result in the reduced amount of motion in the shoulder, causing it to become worse. Pain will increase after periods of immobility such as after a sleep in the morning.

Frozen stage – This is the stage where the shoulder will become much stiffer and movement is almost impossible. Usually in this stage, pain does not increase nor go away. Patients will often feel that this is due to them getting used to the pain and they are usually resigned to a lifestyle requiring little use of their shoulder.

Thawing stage – This is the final stage where improvements are slowly seen. The pain in the shoulder will start to go away and shoulders will become less stiff. Patients will be able to move their shoulder much more than before.

Impingement of the shoulder is an extremely common problem associated with shoulder pain. It occurs due to the impingement of tendons in the shoulder. Repeated usage of the shoulder joint will increase the chances of one suffering from shoulder impingement. This is especially so for athletes involved in sports such as tennis, swimming and badminton. Unlike other injuries, pain is extremely persistent in shoulder impingement and will affect all of the daily activities.

The structure giving our body its shape are the bones and surrounding it are the muscles. When an injury is suffered, blood will rush to the site in order to combat against infection. When this happens, the area will swell up and lead to a chain event. The swelling up of muscles will create tremendous pressure and impinge onto soft tissues such as the ligaments and tendons.

The usual symptoms associated with shoulder impingement include tenderness and soreness. There will be persistent pain throughout that does not go away with treatments such as using hot pack or massages. Over time, the shoulder muscles will weaken and it is nearly impossible to place the arm over your head. Prolonged impingement will lead to the tearing of the shoulder muscles, leading to a rotator cuff injury.

Symptoms of a shoulder impingement is classified into 3 different stages from 1 to 3. Stage 1 involves young patients who are below 25 years. In this stage, the only type of symptom observed is swelling and imflammation. This is due to the ability of the body to repair itself. In stage 2 which involves people from 25 years to 40 years, there will be a significant loss of ability to use the shoulder joint due to it weakening. In stage 3 which happens to people above 40 years old, the symptoms will be much more serious as it often involves the tendons, muscles and bones.

The initial stages of treatment is non-surgical. Oral medications such as aspirin and ibuprofen will be prescribed in an attempt to reduce inflammation. Physical therapy will also be conducted to strengthen the shoulder muscles and improve the range of motion and rotation. If these do not seem to have an effect, a cortisone injection will be injected directly to combat infection. If no improvement is seen after 2 months, the patient will have to undergo a MRI scan and a surgery will need to be performed if it is diagnosed to be a rotator cuff tear.

A slap tear is an injury to the shoulder. SLAP stands for “superior labrum, anterior to posterior”. This means that the top portion of the labrum is injured from the front to the back. The labrum is a ring of tissue located around the shoulder socket and it is there to stabilize the shoulder due to the extensive amount of movement associated with it. So what exactly causes a SLAP tear and what are the symptoms? This article will help to answer some of these questions.

Our shoulder is made of a ball and socket joint consisting of three different bones. The bones are the upper arm bone, the shoulder blade and the collarbone. The head of the upper arm bone is designed to fit nicely into the socket in the shoulder blade. Each person’s ball and socket joint is unique to him only. The labrum is a thick and strong fibrous tissue that helps to deepen the socket and promote stability to the shoulder joint. It also helps to attach the ligaments and tendons in the area.

A SLAP tear will occur from the area just in front or behind the biceps tendon. SLAP injuries were first observed in baseball players due to the nature of the game. SLAP tears are often due to repeated usage of the shoulder joint. It can also be due to sudden trauma to the shoulder such as a traction force or a pull on the arm. An attempt to break a fall using the shoulder can also be responsible.

The most accurate symptom of a SLAP tear is pain. However, almost everything can cause pain! Almost every movement associated with the shoulder joint will result in pain for the patient. There will also be a decrease in shoulder strength and a feeling of instability. The range of motion will also be significantly decreased. Baseball players may also observe a decrease in the velocity of their throw after pitching.

A trained medical specialist should only diagnose SLAP tears. There are several tests such as the O’Brien’s test, Apprehension Sign and Jobe Relocation Test that are highly reliable when used together as a whole package. This can be aided by a MRI scan which will help to identify the presence of a SLAP tear and the exact location.

A SLAP tear is a challenging medical injury and the treatment must be done in a timely manner due to the many ptifalls in the diagnosis and management of such injury.

Dislocated shoulders are common injuries following a direct trauma to the arm. Recovery period is lengthy and is usually in the region of 3 to 4 months before healing is complete. When someone uses the word “dislocated shoulder”, it simply means that the shoulder bone had popped out of the socket. Why are shoulders so prone to dislocation? This is simply because of the wide range of motion the shoulder provides. To cater to the mobility, the shoulder joint is designed like a ball and socket joint. The arm bone is the ball and is inserted into a socket. However, this is rather unstable and the arm can pop out easily. Most shoulder dislocation is at the lower front, as it is shallower. Let’s discuss about some of the symptoms and treatments for a shoulder dislocation.

Symptoms

The symptoms are fairly straightforward. The first thing is the onset of severe pain at the shoulder joint followed by the inability to use it at all. It will be nearly impossible to lift up your arm. The shoulder will also be soft as the bone is now displaced towards the front. The shoulder may also be slightly deformed and bits of the bone may be poking out of the skin.

Treatment

Immediate medical response is required for a speedy recovery. The first step that doctors will do is to try and pop the shoulder bone back into the socket. This is due to the body’s response to injury and it will cause the area to be swollen and inflamed. Therefore, the faster the joint is reconnected, the better it is. The next objective is then to reduce the swelling. Ice is a cheap and effective method to bring down the swelling and soothe the affected muscles and tissues. It is advisable to ice the area every few hours for the next 3 days. In order to prevent excessive movement that may hinder the recovery, an immobility arm sling should be used. This will provide support to the shoulder and reduce the stress. If the pain is too unbearable, anti-inflammatory painkillers should be consumed. The medication will help to bring down swelling effectively and numb the pain.

A dislocated shoulder is not a laughing matter and medical treatment should be sought immediately. Due to the wide use of the shoulder, an injury there will cause excessive disturbance to our daily lives. In order to prevent this, defensive techniques and proper protective gears should be worn during certain activities that are extreme.

Shoulder rehabilitation exercises are extremely important for the post-recovery following a shoulder injury or surgery. Although it may look simple and easy to do, it should only be performed under the supervision of a physical therapist or a doctor to ensure that you are working the right muscles. This is especially so for surgery patients as you do not want to further aggravate the wound. In this article, we will look at some useful rehabilitation exercises for shoulder injuries.

Shoulder rehab exercises are classified into 3 main categories: early stage, mid stage and final stage. In the early stage, the main purpose is to allow the injured tissues, tendons and muscles to heal, prevent scarring and regain your full range of motion. In the mid stage, the regaining of strength is the main purpose to help better support the injured shoulder. Lastly in the final stage, the full strength you had before the injury should be achieved.

Rotator cuff stretching

The rotator is a group of muscles and tendons that act together to stabilise the shoulder joint. Due to the amount of work and repeated stresses they go through, they are the most common cause of shoulder pain and injury. There are many good exercises that aims to strengthen only the rotator cuff but these require extreme care when performing it.

Side external rotation

The side external rotation is a simple exercise that you can perform in the comfort of your own home. Lie on your side with a pillow supporting your head. Place one arm on your stomach with a dumbbell and the other under the pillow. Slowly lift up the dumbbell to chest level and return. Repeat this exercise for 15 times for a total of 3 sets.

Horizontal abduction

In this exercise, lie on your stomach on an elevated platform such as a bed or a table. Leave one arm hanging over the side holding the dumbbell. Slowly lift up the arm until it is parallel with the table and return. Repeat this exercise for 15 times for a total of 3 sets.

Row with external rotation

Begin in the same position as the side external rotation. Instead of lifting your arm parallel to the table, lift it forward this time. You should perform a rowing motion until the elbow is parallel with your shoulder. Slowly rotate your forearm back to the initial position. Repeat this exercise for 15 times for a total of 3 sets.

Do you have a job that requires prolonged sitting at your desk, clicking onto that dreadful mouse? Spending hours at a desk bound job without being able to walk around and stretch your muscles can cause pain in your body. Do you frequently feel a tight and burning sensation at your shoulder whenever you click on the mouse? Patients always have the wrong impression that if they sit ergonomically, they will not suffer from these injuries. However, even if the keyboard and screen are arranged in an ergonomically way, the position of the mouse can cause havoc if it is incorrectly placed.

The very first thing you should do is to eliminate the cause of the pain. And that is to reach for the power socket, remove the cable and dump the entire CPU into the nearest bin. But since you are 99.99% unable to do that, you should look at the second option and that is to perform strengthening exercises with the help of free weights.

Upper back stretch

Stretching is an excellent way to help relieve mouse shoulder. Although it cannot strengthen the back muscles, it helps to loosen the stiffness and the pressure that was built up in that area. The benefit of stretching is that it can be performed anywhere, anytime, even in the comfort or your office. You will need to lie down on your stomach preferably on a yoga mat. Slowly lift your head and legs off the mat while stretching your hands behind your back. You will be able to feel intense stretching at your back. Hold in the position for 10 seconds and repeat for 3 sets of 15. You should aim to perform this every other hour when possible.

Shoulder shrugs

Shoulder shrugs are an excellent exercise to help strengthen the upper shoulder muscles. Hold the free weights with both hands and shrug your shoulders in an upwards direction, hold for 3 seconds and return back to the starting position. Strong upper shoulder muscles can resist tearing and straining. Repeat for 3 sets of 12 repetitions.

Dumbbell rows

The main difference between a dumbbell rows from a normal row is the muscle group that it engages. Dumbbell rows actively work the upper back muscles to strengthen and tone it. Stand straight with hands legs shoulder width apart. Holding the weights in both hands, stretch your hands perpendicular to the ground out to the sides until it is 90 degrees. Repeat this exercise for 3 sets of 15s.

Mouse shoulder is extremely common to office ladies (OL) due to the long hours of being at the desk. Although the position of the monitor screen and keyboard seems alright, as long as the mouse is at a different level as the keyboard, something will go wrong.

Our shoulder is best described as a ball and socket joint that allows flexible movement in various directions. However, there is a direct trade off between flexibility and stability. Due to the extreme flexibility, it is unstable and is very prone to injuries and dislocation. When the labrum is detached from the glenoid, it adds to the instability. It is very easy for the shoulder ball to pop out of the socket and when this happens, it will tear the inferior glenohumeral ligament, leading to an injury called Bankart Lesion. To recover fully, either an arthroscopic or an open surgery called the Bankart Lesion Repair will need to be carried out.

Most surgeons prefer to carry out an arthroscopic surgery due to the higher success rates, lower chances of infection and shorter recovery time. Arthroscopy is a minimally invasive surgery that involves making small incisions to the surgical site to allow the placement of small cameras and surgical tools. Due to its minimally invasive nature, the wound is very much smaller and that leads to a lower risk of infection and faster recovery process. Prior to the surgery, the patient will need to go on a food and drink fast after midnight. During the surgery, the surgeon will reattach back the labrum to the bone along the glenohumeral. The entire shoulder structure will not be modified and there is not a need to detach the subscapularis muscle. You will wake up with a sling and you should always wear it when you are sleeping to immobilise your shoulder to prevent further aggravation of your injury. It will need to be worn religiously for around 3 months.

As general anaesthesia is administered before the surgery, you will not feel any pain immediately when you wake up. However, once the effects of the anaesthesia wears off, the immediate pain will be excruciating. To prevent this sudden onset of pain, you should consume painkillers around 30 minutes before the anaesthesia wears off. To reduce swelling, you should apply ice pack to the surgical site, bearing in mind to always keep the wound nice and dry. You will be unable to use your affected hand for a few weeks. To prevent muscular atrophy, you will need to start performing physical therapy exercises under the guidance of a physical therapist. Physiotherapy will help to reduce scarring and regain the range of motion of your shoulder. It will also help to build up and strengthen your muscles to better support your weakened shoulder joint.

To enable you to continue leading a high quality lifestyle, a Bankart Lesion Repair procedure will need to be carried out to surgically reattach your labrum. This will help to prevent future reoccurrence of your shoulder slipping out of the socket. Although the initial period after surgery will be extremely restrictive, you should persevere on and aim for a speedy recovery.

Rest and recovery is probably the most important part of your exercise regime. Sufficient rest is required to maintain high level performance levels but many people still choose to over train and overuse their muscles. Too much rest will cause you to lose the intensity while too little will cause you to burn out fast. You need to strike a balance between rest and training. Repair and strengthening of the body doesn’t take place during the exercise itself. Instead, they happen when the body is at rest.

Recovery starts the moment you stop exercising. The glycogen in your muscle will be replenished and your body will start to repair muscles that are damaged such as minor muscle tears. It is through this process that your muscles get stronger and firmer. Imagine yourself twisting a paper clip now. The more you twist it, the stronger and more difficult it becomes. Your muscles will be able to withstand stronger loads the next time. However, all these are only possible through rest and recovery.

Sufficient recovery time also helps to burn more fats in your body. You can be doing a lot of cardiovascular training but without sufficient rest, you cannot burn off the fats effectively. Recovery allows the body to have time to fully stretch and contract the muscles and increase the heart rate. This increases metabolism and eat away excess fats.

Many athletes suffer from injuries simply because they over train and overuse their muscles. Without sufficient recovery periods, the muscles are unable to cope with the intense activities going on and pre-existing injuries will be amplified. Insufficient rest will also cause you to lose focus on what you are doing at the moment and this can be very dangerous, especially if you are lifting heavy weights.

Another extremely important reason why recovery is important is to allow sufficient rehydration of the entire body. Intensive training will use up all the fluids in the body and if they are not replenished, it can cause muscle cramps and even cause the body to break down. The muscles need to be constantly fed with electrolytes to keep them in optimum condition.

Rest and recovery are the most important part of a training regime. Although you may be tempted to not rest during exercises hoping to gain more muscles, it can lead to injuries and cause a negative effect for the body. Recovery also helps to repair the body and prevent injuries such as shoulder pain or elbow pain especially if you are playing sports such as tennis.